Individual
GRACE THACKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1800 MAIN ST W, LOCUST, NC 28097-7700
(704) 781-4090
Mailing address
2675 COURT DR, GASTONIA, NC 28054-1478
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
12/17/2024
Last updated
12/17/2024
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